Promoting Nursing Excellence within Belfast City Hospital Trust Continuing Professional Development

Continuing professional development (CPD) or life-long learning is one method of supporting quality improvement in practice. CPD affords nurses the opportunity to develop their knowledge and skills to maintain the required level of practice from the moment they first register until they retire. This learning takes place in many forms, ranging from formal classroom-based courses to one-to-one learning through systems of mentorship, perceptorship and clinical supervision.

The Trust also recognises that continuing professional development makes an important contribution to clinical governance. It recognises the need for registered nurses, in the interests of patients and clients, to maintain and improve their knowledge and skills throughout their professional lives.

There are structured and supported personal development plans and the directorates offer many exciting career pathways as can be seen by the extensive range of specialist posts. The aim of these initiatives is to improve patient care, enhance the skills of individual practitioners and encourage career development.

Nurses in all the directorates have the opportunity to attend Queen's University and the University of Ulster and other educational establishments to attain post-registration training and qualifications.

The Belfast City Hospital is a university teaching hospital providing key regional services and local acute services. Research is an important mechanism by which we improve the quality of care within the Trust. A multidisciplinary approach is taken with medical staff, nurses and allied health professionals collaborating on research projects. Nurses have an important contribution to make to the development of research projects that address clinically significant research problems. In addition, a substantial proportion of nurses undertake postgraduate research as part of masters and doctoral programmes of education. University staff provide academic supervision and the nurses are supported by the Trust's research facilitator.

Nurses are encouraged and facilitated to publish work in professional journals and present their work at conferences; we have an excellent publication record.

• The difficult asthma patient's perspective of taking cortosteroid therapy

• Developing a tool to evaluate patient satisfaction in an acute hospital setting

• Patients' experiences of cardiac rehabilitation before coronary artery bypass surgery

• Exploring the palliative care needs of patients with a non-cancer diagnosis

• Why do respiratory patients continue to smoke? A qualitative study

• Does Immediate Life Support Training influence nurses' skill deployment during subsequent cardiac arrest?

In summary, there is a vibrant research culture within the Belfast City Hospital Trust. Join us to develop your professional career in this way.

The Nurse Bank is managed within the Directorate of Nursing. We operate the largest corporate Nurse Bank in Northern Ireland offering work in all directorates and departments including those at Belvoir Park Hospital.

Bank staff are paid weekly offering rates competitive with commercial agencies. Bank nursing offers flexibility with provision for our staff to have first choice on any requests from all wards and departments. The Nurse Bank offers the opportunity to work on short term block bookings on particular wards as well as responding to day-to-day requests.

Nurses and nursing auxiliaries employed in Belfast City Hospital Trust can join by filling in a form available from the Nurse Bank office on A Floor.

Application forms for others wanting to join can be obtained from the Trust's Personnel Department.

We provide paid, mandatory training and induction days for all new entrants as well as offering further development opportunities.

The rotational system allows new staff in the first year of service in this Trust to move around pre-selected directorates in a planned and equitable manner to accommodate both the new staff and the directorate management.

• To give new registered nurses an opportunity to experience work in different directorates or specialities

• To enable new registered nurses to be more informed and knowledgeable of the Hospital's clinical profile

• To enable new staff to select at the end of their rotation the Directorate in which they would most prefer to work

• To maintain a more generic approach to the development of nurses at junior level

• To focus during rotation on staff perceptoring, clinical supervision and in-service training, including Staff Nurse Induction Programme and all mandatory training

For more details contact Mr Peter O'Reilly - Senior Nurse – Telephone (028) 9032 9241 Ext. 3287 or email peter.oreilly@bch.n-i.nhs.uk

Acute Medicine; Geriatric Medicine; Respiratory Medicine and a purpose built Endoscopy Suite.

• Ward Floor 6 provides acute medical services. Gastroenterology and Endocrinology services for diabetic patients are developing rapidly in line with new techniques and standards of care.

• Ward Floor 8 provides acute medical services and specialises in care of the patient with respiratory diseases. It also houses the regional adult Cystic Fibrosis Unit and is an investigation centre for patients with sleep apnoea.

• The Endoscopy Suite on the ground floor of the Tower provides highly specified facilities for gastrointestinal and respiratory endoscopy.

The Department of Healthcare for the Elderly provides continuing care, respite care, rehabilitation and acute care for the elderly. The Unit has dedicated Physiotherapy and Occupational Therapy Departments. Multidisciplinary teams work closely within the Unit to provide a friendly and informal approach to the provision of care for our elderly patients. Nursing staff rotate on a regular basis through the various wards.

• Ward Floor 7 in the Tower provides acute care of the elderly and is involved in acute emergency medical take-ins. It also houses specialist stroke beds which are served by a very effective multidisciplinary team.

The Oncology Haematology Directorate is an integral part of the Cancer Centre providing treatment and care for people whose lives have been affected by cancer. We provide a regional service and network closely with colleagues from the cancer units, primary care and the cancer charities, ensuring a seamless approach. We have a reputation for excellence in care, innovation in practice and a demonstrable interest in nursing research.

This directorate is a welcoming and friendly place to be, where team-working and face-to-face contact really count and where we continue to look for dedicated people to join us. In addition to the multi-professional team, you will have the opportunity to work with our experienced cancer nurses, healthcare assistants, clinical nurse specialists, clinical research nurses, practice development nurses, ward leaders and senior clinical nurses. We offer a wealth of innovative practice development programmes, with many in-house learning opportunities and support for external educational courses.

Our shared vision for nursing within the directorate is to provide a patient-centred service where:

• practice is informed by evidence

• the therapeutic potential of nursing is valued

• the infrastructure supports all of the above

Nurses have the opportunity to work in both the Belvoir Park Hospital and Belfast City Hospitals.

The Directorate of Nephrology is the regional centre for the treatment of renal disease in Northern Ireland. It is a rapidly expanding and changing service and the skills and knowledge of the renal nurse have had to change to meet these demands. Renal nurses have the autonomy to monitor and evaluate patient care, give expert advice and provide psychological support to a caseload of patients. It is a complex and challenging area where nurses work closely with other professionals to provide the best care for renal patients and their families.

Nephrology includes a 31 bedded inpatient ward. This newly refurbished unit opened in July 2004 offering nurses the opportunities to develop in this expanding speciality.

The Regional Renal Dialysis Unit has 43 stations providing outpatient treatment for 126 patients each day. This is a nurse-led unit and one of the largest in Europe.

• Expansion of nurse-led outpatient pre-dialysis clinics

• Development of a nurse education Programme. A structured staff development programme has been established to develop nursing practice.

Nurses are encouraged to undertake the Renal Nursing Course at QUB, the Specialist Practitioners Course and any other education or training that is relevant to this specialist area of nursing.

This directorate comprises: cardiology; clinical genetics; dermatology; neurology and rheumatology and offers nurses the opportunity to work in the following area:

• 6-bedded coronary care unit supported by a 22-bedded acute cardiology ward

• 23-bedded procedural ward with three interventional rooms, which provides support to the cardiovascular unit and is one of two tertiary cardiology units in Northern Ireland.

• non-invasive cardiac investigation department.

The Dermatology Department provides a comprehensive programme of care to patients with skin conditions. Newly established nursing posts in research, quality and education ensure patients and staff alike receive maximum opportunity to gain knowledge of skin conditions and base care on established evidence. Our patients run their own support group, which meets at intervals through the year and keeps close contact with the nursing and medical team. As skin conditions affect the patient physically and psychologically, our Nurse Education Programme now includes training in counselling skills.

This Directorate has a central role in providing treatment and care for people whose lives have been affected by mental illness. We provide a local service and network in partnership with colleagues from mental health trusts, primary care and voluntary and statutory mental health organisations ensuring a collaborative continuum of integrated services. We have a reputation for quality in care, innovation in evidence-based practice and a demonstrable interest in developing new roles for mental health nurses.

Both students and new nursing staff value the experience of working in this directorate where staff are supportive and friendly. The development of new team working structures has led to the progression of personal and professional planning, considering nurse training and development needs. We look forward to appointing mental health nurses who will contribute to the development of innovative practices. In addition to the multi-professional team, you will have the opportunity to work with our experienced mental health nurses, healthcare assistants, specialist nurse practitioners, psychiatric liaison nurse, regional psychosexual nurse therapist, nursing sisters, charge nurses and team leaders. We offer opportunities for practice developments, with in-house learning and support for external educational courses.

• Windsor House Inpatient team - 35 beds

• South Belfast Day Hospital

• Windsor Psychogeriatric Day Hospital

• Severe Mental Illness Team

• Primary Care Mental Health Team

• Mental Health Liaison Service

• Early Intervention in Psychosis Team

• Out-patient service including Clozaril/Lithium nurse-led clinic

• Regional Psychosexual Clinic

The Directorate of Surgery provides inpatient and day patient services for patients. The directorate comprises a number of specialities including:

• General Surgery/Breast Services including Head and Neck Urology Services

• Gynaecology

• Vascular/General Surgery - This unit participated in the setting up of the first vascular course for nurses to be held in Northern Ireland

• ENT - adult and paediatric Nursing staff run a Tracheotomy Support Group for parents that meets on a regular basis

• Accident & Emergency - The Accident & Emergency Department consists of two fully equipped resuscitation areas and examination rooms for both major and minor cases. There is also a 15-bedded observation ward situated adjacent to the department. In addition to patient assessment, investigation and treatment, the department fulfils a training and research role for medical, nursing and paramedical staff in accident and emergency clinical care. The department first achieved Charter Mark in 1996 and was the first accident and emergency department in Northern Ireland to receive the highly coveted award. It has since been re-accredited.

• Tower Theatres

• Day Surgery UnitThe Day Surgery Unit is a speciality area comprising of two theatres and a urodynamic room. Patients are cared for pre-operatively, intra-operatively and post-operatively by a dedicated and caring nursing staff. Opportunities exist for nursing staff to develop skills relating to anaesthesia and post-operative recovery. There are day surgery lists in general surgery, urology and gynaecology.

• Dufferin Theatres - A separate unit specialising in ENT surgery (adult and paediatric) to include Cochlear Implants.

• Intensive Care Unit – A seven bedded general adult intensive care unit where most patients have multi-organ failure and require several systems require support. This means artificial ventilation for most, complicated drug therapy for many and continuous or intermittent dialysis for more than a few. Working in ICU should be considered excellent basic training for all nurses even for a period of 6-12 months.

The Outpatient Department provides for over 180,000 attendances annually, and has held a Charter Mark for quality since 1994.
Nurses have the opportunity to work in almost every speciality. In addition there are many nurse-led services including Anticoagulant Clinic, Heart Failure Clinic and Wound Management Clinic.

Throughout the Trust there is a growing band of Specialist Nurses covering topics from Andrology Support through Nutrition to Vascular.